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Chapter 16 Personality Disorders

Chapter 16 Personality Disorders. F. Menu. Mental health continuum for personality disorders. (Fig. 16-1). 16-2. B. F. Menu. Personality Disorders. Cluster B Dramatic, Emotional, Erratic Borderline Antisocial Histrionic Narcissistic. Cluster C Anxious, Fearful Dependent

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Chapter 16 Personality Disorders

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  1. Chapter 16Personality Disorders F Menu

  2. Mental health continuum for personality disorders (Fig. 16-1) 16-2 B F Menu

  3. Personality Disorders Cluster B Dramatic, Emotional, Erratic • Borderline • Antisocial • Histrionic • Narcissistic Cluster C Anxious, Fearful • Dependent • Avoidant • Obsessive Compulsive Cluster A Odd or Eccentric • Schizotypal • Paranoid • Schizoid B F Menu

  4. Limit Setting Limits: clear, consistent, enforceable Team: aware of limits, need for consistency • Communicate expectations to client • Be realistic re: which behaviors to limit • Clear consequences of exceeding limits • Follow through with consequences in non-punitive manner • Assist client to limit own behavior • Assess insight and motivation to change • Avoid power struggles B F Menu

  5. Impulsive Behavior: Interventions • Identify antecedent needs and feelings • Discuss current/previous impulsive acts • Explore impact on self and others • Recognize cues to impulsive behavior • Refer or teach needed coping skills • Discuss alternatives to impulsive behavior • Role play new skills • Provide feedback • Support new skills • Identify strengths and effective communication B F Menu

  6. Cluster A Clients: Interventions • Be aware of client isolation, suspiciousness • Avoid being “too nice,” overly friendly • Use neutral, kind approach • Clear, straightforward explanations • Simple, clear language • Give warning about changes, reasons for delay, medication side effects B F Menu

  7. Borderline Personality Disorder: Interventions • Set clear, realistic goals • Be aware of manipulative behaviors • Clear, consistent boundaries/limits • For behavioral problems, review therapeutic goals and treatment boundaries • Avoid rejecting, rescuing • Assess for suicidal, self-mutilating behavior B F Menu

  8. Antisocial Personality Disorder: Interventions • Set clear, realistic limits on specific behavior • All limits adhered to by all staff • Document objective physical signs of manipulation or aggression • Provide clear boundaries, consequences • Guard against letting client make you feel guilty • Guard against being manipulated B F Menu

  9. Narcissistic Personality Disorder: Interventions • Stay neutral, avoid power struggles • Don’t be defensive when disparaged • Convey unassuming self-confidence B F Menu

  10. Histrionic Personality Disorder: Interventions • Understand seductive behavior as a response to stress • Keep relationship professional • Encourage/model use of concrete descriptive language • Teach and model assertiveness B Menu

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